anti-HBc-only condition

[rexx73]

dear community,

first i have to say that i have a chronic hep-c wich i treated for 48 weeks with the new drugs(incivek).i was UND all the way thru the 48 weeks and hope i can become svr.i am now 3 weeks post treatment.
iam a daily hep-c forum user but i dont know much about the hep-b

so now about my question;
ive had an hep-a and hep-b before 20 years also and cleared it both myself.

on my diagnosis they writing

-chronic hep-c
-condition after hep-a,
-condition after hep-b (anti-hbc only) Hbs neg.Anti-HBs neg,Anti HBc pos

when i was at the transplant center before 6 weeks for my hcc screening while still on hep-c treatment they also checked for hep-b dna wich was negative.

i asked why they checked for hep-b dna, because i was worried that maybe i have an hep-b again..
but the leading doc said i have no chronic hep-b and that the anti-hbc condition means that ive had once a hep-b and no further test are required regarding the hep-b.
the secondary doc who made the examination,wrote in a email about the same,and he said they checked because of my anti-HBc-only condition,wich means that iam not 100% immune against hep-b,and some people with anti-HBc-only condition have still some hbv-dna.(wich was negative)
he said that i not have to worry about the hep-b,and its rare that the hep-b is reactivating.(he said it could happen when you are for example on chemo)
he also said that when people had hep-b long time ago its possible that the anti-HBs can became undetectable again

today i had my first post tx apointment(3 weeks post hep-c treatment) and i asked the doc to check for hep-c and for hep-b also, just to be sure about the hep-b.
the hbv dna was tested negative while still on hep-c treatment iam worried that maybe after the hep-c treatment the hbv-dna can come back.


i would be very thankfull if some poeple can explain me about this  anti-HBc-only condition..
marc

[Rome70]

I agree that over a long time antiHbs can become under it is well established fact, but as for hbv it is complicated. you must be sure that  dna is really under, you must check with supersensitive test, it can be that there is dna in very low quantity, that is occult hbv.  but probably it is easier to get vaccina shot and see if you develop antibodies, then you are fine.
I do knot know if hcv treatment can lower hbv replication too and get hbv dna down, so it is better to discuss it with your doctor on your next visit.

[rexx73]

thanks alot for the explanation.
do you agree with my doc that i have no chronic hep-b as the hbs is negative,and there was no hbv-dna found?

so he could be right when he says that over a long time period the anti-hbs can become undetectable?

[Rome70]

Please read this first

http://depts.washington.edu/hepstudy/hepB/clindx/core/discussion.html

Evaluation and Management of Patient with Isolated Hepatitis B Core Antibody
The clinical approach to the evaluation and management of isolated anti-HBc varies depending on the clinical situation. We recommend the following approach:
For patients with no history of risk factors for hepatitis B, the isolated anti-HBc should be considered a false positive test and the patient considered non-immune.
For patients with risk factors for HBV infection, such as the patient in this case, there are several options. These patients may be treated as non-immune and vaccinated with the 3-vaccine series. Alternatively, some experts recommend repeating the measurement of total anti-HBc. If the repeat test is negative (thus suggesting the initial test was a false-positive result), the patient should receive the complete HBV immunization series. If the repeat anti-HBc test is positive, the patient most likely has resolved infection with gradually waning anti-HBs titers. There is a lack of consensus regarding whether these patients should receive HBV vaccination. The options in this situation include (1) do not give any doses of vaccine, (2) give one dose and check the anti-HBs titer to see if patient has a "booster" anamnestic response (anti-HBs titer greater than 10 IU/L), or (3) give the complete vaccine series.

[rexx73]

sorry if i missunderstand you,but do you mean i can be vaccinated even i had the hep-b already 20 years ago?

[Rome70]

Yes you can loose anti Hbs over time, normaly you should be revaccinated in this case, ask your doctor about it.